Situation awareness in undergraduate nursing students managing simulated patient deterioration

Nursing work often occurs in complex and potentially hazardous settings. Awareness of patient and practice environments is an imperative for nurses in practice.

Is a contained fire less risky than a going fire? Career and volunteer firefighters

Since fighting fires can pose a great risk to the lives of firefighters, it is important to understand how they perceive risks in dynamic wildfire situations. The aim of the current study was to determine whether career and volunteer firefighters differ in their perception of the risk of a going vs. contained fire and whether descriptions of a fire as either going or contained affected perceptions of risk. It was expected that career firefighters would rate a contained fire as significantly riskier than would volunteer firefighters. The sample consisted of 55 career and 84 volunteer CFA Victorian firefighters (134 males and 5 females). An ambiguous wildfire scenario was presented and described as either going or contained and risk ratings were recorded. Two-way ANOVA results showed that career firefighters rated a going fire as equally risky as a contained fire. On the other hand, volunteer firefighters perceived a fire described as contained to be significantly less risky than a fire described as going, despite the fact that the same fireground conditions were described in both cases. It was concluded that a framing effect had occurred and that career firefighters demonstrated a higher level of situation awareness than volunteer firefighters due to their heightened levels of risk perception when exposed to contained wildfire scenarios. A practical implication of the current research is that those conducting firefighting briefings need to be aware of possible framing effects in the way information is presented to firefighters and need to ensure that all briefings make risks cognitively salient to firefighters.

Undergraduate nursing students' performance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: an Australian multi-centre study

Objectives
This paper reports the quantitative findings of the first phase of a larger program of ongoing research: Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACTTM). It specifically aims to identify the characteristics that may predict primary outcome measures of clinical performance, teamwork and situation awareness in the management of deteriorating patients.

Design
Mixed-method multi-centre study.

Setting
High fidelity simulated acute clinical environment in three Australian universities.

Participants
A convenience sample of 97 final year nursing students enrolled in an undergraduate Bachelor of Nursing or combined Bachelor of Nursing degree were included in the study.

Method
In groups of three, participants proceeded through three phases: (i) pre-briefing and completion of a multi-choice question test, (ii) three video-recorded simulated clinical scenarios where actors substituted real patients with deteriorating conditions, and (iii) post-scenario debriefing. Clinical performance, teamwork and situation awareness were evaluated, using a validated standard checklist (OSCE), Team Emergency Assessment Measure (TEAM) score sheet and Situation Awareness Global Assessment Technique (SAGAT). A Modified Angoff technique was used to establish cut points for clinical performance.

Results
Student teams engaged in 97 simulation experiences across the three scenarios and achieved a level of clinical performance consistent with the experts' identified pass level point in only 9 (1%) of the simulation experiences. Knowledge was significantly associated with overall teamwork (p = .034), overall situation awareness (p = .05) and clinical performance in two of the three scenarios (p = .032 cardiac and p = .006 shock). Situation awareness scores of scenario team leaders were low overall, with an average total score of 41%.

Conclusions
Final year undergraduate nursing students may have difficulty recognising and responding appropriately to patient deterioration. Improving pre-requisite knowledge, rehearsal of first response and team management strategies need to be a key component of undergraduate nursing students' education and ought to specifically address clinical performance, teamwork and situation awareness.

Towards a resilience management framework for complex enterprise systems upgrade implementation

The lack of knowledge of how resilience management supports enterprise system (ES) projects accounts for the failure of firms to leverage their investments in costly ES implementations. Using a structured-pragmatic- situational (SPS) case study research approach, this paper reports on an investigation into the resilience management of a large utility company as it implemented an ES upgrade. Drawing on the literature and on the case study findings, we developed a process-based resilience management framework that involves three strategies (developing situation awareness, demystifying threats, and executing restoration plans) and four organisational capabilities that transform resilience management concepts into practices. We identified the crucial phases of ES upgrade implementation and developed indicators for how different strategies and capabilities of resilience management can assist managers at different stages of an ES upgrade. This research advances the state of existing knowledge by providing specific and verifiable propositions for attaining a state of resilience, the knowledge being grounded in the empirical reality of a case study. Moreover, the framework offers ES practitioners a roadmap to better identify appropriate responses and levels of preparedness.

Managing women with acute physiological deterioration: student midwives performance in a simulated setting

OBJECTIVE: Midwives' ability to manage maternal deterioration and 'failure to rescue' are of concern with questions over knowledge, clinical skills and the implications for maternal morbidity and, mortality rates. In a simulated setting our objective was to assess student midwives' ability to assess, and manage maternal deterioration using measures of knowledge, situation awareness and skill, performance. METHODS: An exploratory quantitative analysis of student performance based upon performance, ratings derived from knowledge tests and observational ratings. During 2010 thirty-five student, midwives attended a simulation laboratory completing a knowledge questionnaire and two video, recorded simulated scenarios. Patient actresses wearing a 'birthing suit' simulated deteriorating, women with post-partum and ante-partum haemorrhage (PPH and APH). Situation awareness was, measured at the end of each scenario. Applicable descriptive and inferential statistical tests were, applied to the data. FINDINGS: The mean total knowledge score was 75% (range 46-91%) with low skill performance, means for both scenarios 54% (range 39-70%). There was no difference in performance between the scenarios, however performance of key observations decreased as the women deteriorated; with significant reductions in key vital signs such as blood pressure and blood loss measurements. Situation, awareness scores were also low (54%) with awareness decreasing significantly (t(32)=2.247, p=0.032), in the second and more difficult APH scenario. CONCLUSION: Whilst knowledge levels were generally good, skills were generally poor and decreased as the women deteriorated. Such failures to apply knowledge in emergency stressful situations may be resolved by repetitive high stakes and high fidelity simulation.

Corrigendum to "Undergraduate nursing students' performance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: An Australian multi-centre study" [Nurse Educ. Today 34(5) (May 2014

The authors regret that the original text: The SAGAT instrument has been previously validated (Bell et al., 2006) is incorrect and should read: The SAGAT technique has been demonstrated as valid, sensitive and reliable measure of situation awareness in diverse applications (Endsley, 2000).

Endsley, M. R. (2000) Direct measurement of situation awareness: Validity and use of SAGAT. In Endsley, M.R. & Garland, D.J. (Eds.), Situation awareness analysis and measurement (pp 147–173). New Jersey: Lawrence Erlbaum Associates.

The authors would like to apologise for any inconvenience caused.

Current situation of practical work in secondary school biology (VCE biology) in Victoria state, Australia

In secondary school biology in Victoria State, Australia, practical work including laboratory exercises, fieldwork and other research activities is carried out more frequently than in Japanese senior high school biology. The authors examined the contents of the practical work and how often such practical work is carried out in some urban and rural secondary schools in Victoria. The topics of biology practical work were based on the VCE Biology Study Design which was published by the Victorian Board of Studies. Some of the activities continued for some weeks. Sometimes students went out from their school for fieldwork for a few days. The average number of practical work per credit was about 4. This number is consider ably larger than the value (2.3 per credit) which was reported on senior high schools in Osaka Prefecture. Why so often can the practical work be carried out? The main reason is that as well as the scores of ordinary paper tests, the evaluation of each practical work is taken into consideration at the entrance examination of universities and other tertiary education institutes in Victoria State.

Food industry awareness of consumers` plant food beliefs

Abstract: Purpose – The aims of this study were to examine farmers' and food processors' alignment with consumers' views about plant foods and their intentions to produce plant foods. Design/methodology/approach – Data on plant food beliefs were collected from mail surveys of farmers, food processing businesses and random population samples of adults in Victoria, Australia. Findings – There were strong differences between consumers' beliefs and farmers' and food processors' perceptions of consumers' beliefs. For example, a higher proportion of farmers and processors believed that consumers would eat more plant foods if more convenience-oriented plant-based meals were available than consumers themselves agreed. Farmers appeared to be more aware of or aligned with consumers' beliefs than were processors. One- and two-thirds of farmers and processors respectively were planning to grow or process more plant foods, which bodes well for the availability of plant and plant-based foods. Research limitations/implications – Study limitations include the small food industry sample sizes and possible response bias, although analysis suggests the latter was low. Future research could survey a larger sample of food industry representatives, including those from other sectors (e.g. retailers). Practical implications – Education of consumers and industry groups on plant foods and better lines of communication from consumer to processor to farmer, are required. Originality/value – To the authors' knowledge, this is the first study to examine farmers' and food processors' awareness of consumers' beliefs about plant foods. This issue is important for those involved with the production and marketing of plant foods or with food, farming and health policy.

Factors influencing awareness of community-based shorebird conservation projects in Australia

We examine the awareness of potential volunteers (n = 360) living near nine community-based shorebird conservation projects. About half of the people sampled (54%) were unaware of the nearest project. Awareness of interviewees varied substantially among projects (28-78%). Apart from gaining awareness of projects through membership of natural history groups (43%), many respondents heard of projects through friends and relatives (20%), rather than through media such as newspapers (14%) and television (2.3%). We demonstrate that community-based projects can be quantitatively and critically assessed for awareness. The use of rapid, cost-effective assessments of awareness levels has application in many conservation projects.

Awareness support in a component-based collaborative environment

The awareness support for activities in collaborative environments is important for effective collaboration and coordination. It helps people know who else is doing what in a shared workspace. The amount of awareness needed varies due to specific roles users undertake during collaboration. While emphasizing the importance of roles, we introduced related research on awareness and a component-based collaboration metamodel. Based on that metamodel, several awareness elements were discussed and implemented in a collaborative environment LiveNet4. Model view controller pattern used to construct the Web-based interface of LiveNet4 was also introduced at the end of this paper.

Supporting awareness in asynchronous collaborative environments

One of the major challenges in asynchronous collaborative environment is to provide a sense of awareness of other users actions. The amount of awareness needed varies due to specific roles users undertaking during collaboration. While emphasizing the importance of roles, this paper discusses awareness-role relationship and proposes a role-based approach to specifying the awareness characteristics in asynchronous collaborative environment. An example of implementation of role-based awareness supporting system LiveNet4 is also illustrated at the end of this paper.

The construct validity of brief continence self-assessment awareness questionnaires

The aim of this study was to develop brief versions of the continence self-assessment awareness questionnaire (CSAAQ), sensitive to gender-specific experiences of incontinence, and to evaluate their construct validity. Recruitment took place at four Victorian healthcare settings during 2001 and 2002. A total of 431 participants completed the CSAAQ following an appointment or hospital discharge. Factor analyses performed on CSAAQ items demonstrated there were three factors (urinary incontinence symptoms, faecal incontinence symptoms, lifestyle adjustment behaviours) for both women and men. The urinary and faecal items that loaded on their respective factors were different for women and men. Consequently two versions of the CSAAQ were developed; one for males and one for females. Analyses supported the construct validity and internal consistency reliability of the gender specific questionnaires. The brief gender specific CSAAQs could be produced as a single questionnaire with separate sections for female and male specific items. The brief CSAAQs are suitable for use as an incontinence self-assessment questionnaire to increase awareness of individual incontinence issues and to encourage health-seeking behaviours.